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Mixed-Reality-Assisted Puncture of the Common Femoral Artery in a Phantom Model
Christian Uhl1, Johannes Hatzl1, Katrin Meisenbacher1
1Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany.
Insights
Mixed-reality (MR) navigation assists common femoral artery puncture, achieving 93.3% technical success in a phantom model. This novel approach shows feasibility for precise endovascular interventions, reducing potential complications.
Area of Science:
- Medical Imaging
- Interventional Radiology
- Surgical Navigation
Background:
- Percutaneous femoral arterial access is crucial for endovascular interventions.
- Complications arise from suboptimal puncture location and poor vessel visualization.
- Improved guidance systems are needed to enhance procedural safety and efficacy.
Purpose of the Study:
- To evaluate the feasibility of mixed-reality (MR)-assisted common femoral artery puncture.
- To assess the positional error of MR-guided needle placement in a phantom model.
- To determine the potential of MR technology in improving percutaneous access accuracy.
Main Methods:
- A proof-of-concept study using a phantom model.
- Mixed-reality (MR) navigation system for guiding common femoral artery puncture.
- Cone-beam computed tomography angiography (CTA) for quantifying needle placement accuracy.
Main Results:
- Technical success rate of 93.3% (14/15 punctures).
- Median axial positional error of 1.0 mm and sagittal positional error of 1.1 mm.
- Median procedure and needle insertion time of 2 minutes.
Conclusions:
- MR-assisted common femoral artery puncture is feasible in a phantom model.
- The technique demonstrates acceptable positional accuracy for potential clinical application.
- Further research is needed to minimize positional errors associated with MR registration.
Abstract:
Percutaneous femoral arterial access is daily practice in a variety of medical specialties and enables physicians worldwide to perform endovascular interventions. The reported incidence of percutaneous femoral arterial access complications is 3-18% and often results from suboptimal puncture location due to insufficient visualization of the target vessel. The purpose of this proof-of-concept study was to evaluate the feasibility and the positional error of a mixed-reality (MR)-assisted puncture of the common femoral artery in a phantom model using a commercially available navigation system. In total, 15 MR-assisted punctures were performed. Cone-beam computed tomography angiography (CTA) was used following each puncture to allow quantification of positional error of needle placements in the axial and sagittal planes. Technical success was achieved in 14/15 cases (93.3%) with a median axial positional error of 1.0 mm (IQR 1.3) and a median sagittal positional error of 1.1 mm (IQR 1.6). The median duration of the registration process and needle insertion was 2 min (IQR 1.0). MR-assisted puncture of the common femoral artery is feasible with acceptable positional errors in a phantom model. Future studies should aim to measure and reduce the positional error resulting from MR registration.
